Enhancing the Pipeline of Pathologists in the United States

The shortage of pathologists in the United States has been a topic of discussion for the past 2 decades. At the 2014 Association of Pathology Chairs (APC)/Program Directors Section (PRODS) meeting, a Pipeline Subcommittee (PSC) of the APC Advocacy Committee was formed with the charge of investigating ways to increase the number of highly qualified United States Medical Graduates entering into pathology. Several online surveys were developed to identify the strengths, weaknesses, opportunities, and threats to recruitment into pathology. Two general pipeline surveys were completed; one was issued in 2014 and is discussed in this article. In 2018, the Medical Education Working Group surveyed the Undergraduate Medical Education Directors Section on the state of undergraduate medical education for pathology; pipeline issues are included in this article from the 2018 survey. Medical schools that reported 2% to 5% or more of their graduates going into pathology were compared with schools where less than 1% went into pathology. About one-third of schools producing more pathology residents had Post-Sophomore Pathology Fellowships. Schools that had a faculty member on the curriculum committee that felt they had little or no control were more likely to have fewer graduates going into pathology. Schools having students view an autopsy as a requirement of graduation were more likely to produce graduates going into pathology. However, none of these characteristics achieved statistical significance. Continued incorporation of best practices for exposure of pathology as a medical specialty as well as outreach to students will be necessary for the future pipeline.